2013-2014 Annual newsletter

The Health Care Specialist Newsletter is designed to notify you about some key points of interest within the Medicare Community. We'll point out a few key points that you need to know. Make sure to refer to our newsletter on an annual basis for new updates on Medicare. Of course you can also always call us for more information.

NOTE: enrollment time to change prescription drug plans or Medicare advantage plans is October 15th thru December 7th.

How are medicare supplements priced?

Plans F,G, & N tend to be the most effective. The same 10 plans are available from several companies. We will find you the best value without charge.

Would you like to compare medicare drug coverage to your own?

Please follow the link below to another page on our site complete with instruction on how to utilize the medicare website to research information about your drug coverage options.
Part D Rx Prescription Drug Comparison Instructions

*NOTE: if the link above takes you directly to the medicare site without listing the guidance instructions at the top of the page then please follow the link below for instructions and print the page for external reference. Then you can click the direct link to the medicare website and continue your drug comparison.

What can you tell me about medicare advantage plan rates?

Several of these plans require no additional premium beyond the cost of your original medicare. They offer prescription drug coverage plus additional benefits.

What are "gaps" in medicare coverage?

"Gaps" are considered the main differences between the most popular medicare coverages. We'll show you a small example of the "gaps" you'll find between Parts A & Plan B below. Our certified professionals are 100% qualified to explain those difficult "gap" questions so you can better decide what coverage is best for you.

Medicare (Part A) - Hospital Services - Per benefit period
A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
  Medicare Pays

Hospitalization*
Semiprivate room and board, genaral nursing and miscellaneous services and supplies:
First 60 days


61st - 90th day
91st day and after:
-While using 60 lifetime reserve days
-After Lifetime reservee days are used, an additional 365 days
-Beyond the additional 365 days








All but $1184


All but $296 a day
All but $592 a day



$0



$0

Skilled Nursing Facility Care*
You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare approved facility within 30 days after leaving the hospital:
First 20 days

21st - 100th day

101st day and after

 

 

 

 

 

 


All approved amounts
All but $148.00 per day
$0

Blood
First 3 pints
Additional amounts

$0
100%
Hospice Care
Available as long as your doctor certifies that you are terminally ill and you elect to receive these services
All but very limited co-payment/co-insurance for outpatient drugs and inpatient respite care
*Notice: When your Medicare Part A hospital benefits are exhausted, the insurer
pays whatever amount Medicare would have paid for up to an additional 365 days
as provided in the policy's "Core Benefits." During this time, the hospital is prohibited
from billing you for the balance based on any difference between its billed charges
and the amount Medicare would have paid.

Medicare (Part B) - MEDICAL Services - Per CALENDAR YEAR
A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
  Medicare Pays

Medical Expenses - INCLUDES TREATMENT IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as: physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment:
First $147 of Medicare Approved Amounts*
Remainder of Medicare Approved Amounts



















$0



Generally 80%
After a $147.00 Yearly Deductible

Part B Excess Charges
(Above Medicare Approved Amounts)


$0
Blood
First 3 pints
Next $155 of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0
$0




80%
Clinical Laboratory Services
- Tests for diagnostic Services



100%
*Once you have been billed the $162 of Medicare approved amount covered
services, your Part B deductible will have been met for the calendar year.

PARTS A AND B
  Medicare Pays

hOME HEALTH CARE - MEDICARE APPROVED SERVICE

Medically necessary skilled care services and medical supplies

100%

Durable medical equipment
(First $162 of Medicare Approved Amounts)
$0
Remainder of Medicare Approved Amounts 80%

I've Heard Enrollment Dates Vary?

Enrollment dates can vary based on a multitude of factors. Some of those factors are based on open enrollment periods whereas some enrollment periods are based on time of year in conjunction with what disabilities you may have. Our qualified professionals are best suited to tell you when a good enrollment time is available for you. Due to the fact that there are so many factors involved for enrollment make sure to contact your qualified Health Care Specialist today for piece of mind and quality services.

- Health Care Specialists